Provider Demographics
NPI:1306022355
Name:SIDHU, RUPINDER (DDS)
Entity Type:Individual
Prefix:
First Name:RUPINDER
Middle Name:
Last Name:SIDHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23261 MEADOWVALE GLEN CT
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-2150
Mailing Address - Country:US
Mailing Address - Phone:206-228-4873
Mailing Address - Fax:
Practice Address - Street 1:2645 NAYLOR RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7255
Practice Address - Country:US
Practice Address - Phone:240-401-4346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-20
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10006921223G0001X
VA04014119301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice